近视性弱视综合治疗方法及疗效对比

Comparative analysis of combined therapy and clinical efficacy for myopic amblyopia

目的:分析短小遮盖+海丁格刷+闪烁红光+红色视力表远距离视功能训练在近视性弱视治疗中的效果。方法:选择近视性弱视患儿甲、乙两组共97例186眼,甲组47例89眼,年龄4～12(平均5.79±1.98)岁,乙组50例97眼,年龄3～10(平均5.92±1.72)岁;其中甲组轻度、中度、高度近视眼分别为16眼、52眼、21眼,乙组分别为18眼、55眼、24眼(χ2=0.004,P>0.05);甲组轻度、中度、重度弱视眼分别为23眼、49眼、17眼;乙组分别为26眼、55眼、16眼(χ2=0.136,P>0.05);甲组患者采用遮盖+闪烁红光+近距离功能训练;乙组患者采用短小遮盖+海丁格刷+闪烁红光+红色视力表远距离视功能训练,所有患者治疗后随访时间24mo,对比分析两种治疗方法在近视性弱视治疗中的疗效。结果:甲组基本治愈率为35.96%,有效率为40.45%,无效率为23.60%;乙组基本治愈率为56.70%,有效率为26.80%,无效率为16.49%,统计学分析差异有统计学意义(χ2=6.022,P<0.05);甲乙两组治疗后近视度数增加≤1.0D,1.0～3.0D及≥3.0D者分别为:甲组3眼、49眼、37眼;乙组4眼、69眼、24眼,统计学分析差异有统计学意义(χ2=5.074,P<0.05)。结论:短小遮盖+海丁格刷+闪烁红光+红色视力表远距离视功能训练法治疗近视性弱视疗效较好,治疗后弱视眼近视度数发展较轻。

AIM： To observe and analyze the clinical effect of minimal occlusion ＋ Haidinger brush ＋ flicker red light ＋ distance visual function training of red E standard logarithm visual acuity chart in treating children with myopic amblyopia. METHODS： Totally 97 children（186 eyes）with myopic amblyopia were treated, 47 children（89 eyes）in group A aged 4-12（5.79±1.98）years old were treated by covering ＋ flicker red light ＋ near visual function training and 50 children（97 eyes）in group B aged 3-10（5.92±1.72）years old were treated by minimal covering ＋ Haidinger brush ＋ flicker red light ＋ distance visual function training of red E standard logarithm visual acuity chart. The patients with mild myopia, moderate myopia and high myopia were 16, 52 and 21 eyes in group A and 18, 55 and 24 eyes in group B（χ2=0.004, P〉0.05）. The patients with low amblyopia, medium amblyopia and severe amblyopia were 23, 49 and 17 eyes in group A and 26, 55 and 16 eyes in group B（χ2=0.136, P〉0.05）. All patients were followed up for 24 months to comparatively analyze the efficacy of two different combined therapies. RESULTS： The recovery rate, effective rate and inefficacy rate was 35.96%, 40.45% and 23.60%, respectively in group A, and 56.70%, 26.80% and 16.49%, respectively in group B（χ2=6.022, P〈0.05）. The patients whose myopic degree developed ≤1.0D, 1.0D-3.0D and ≥3.0D were 3, 49 and 37 eyes in group A and 4, 69 and 24 eyes in group B after therapy（χ2=5.074, P〈0.05）.CONCLUSION：The efficacy is better of minimal covering＋ Haidinger brush ＋ flicker red light ＋ distance visual function training by red E standard logarithm visual acuity chart for treating children with myopic amblyopia and the develop of myopic degree were mild after therapy.